What are the first days after a bone graft like?
In the first days, slight bleeding, swelling and tenderness are to be expected; after the third day the symptoms usually ease. What a graft is and when it is needed is explained in our guide bone graft before implants; this guide covers healing and the journey home. According to the patient information of McGill University’s Oral and Maxillofacial Surgery department, healing usually runs like this:
- First hours: numbness of the lip, cheek and tongue usually wears off after 2 to 4 hours; until then, take care not to bite your lip or cheek.
- First 24 to 48 hours: slight oozing is normal, and traces of blood in the saliva can last a few days. Cool the cheek 20 minutes on, 20 minutes off for the first 24 hours, and keep your head raised for 48 hours.
- Days 2 to 3: swelling is usually at its peak now. From the third day, warm moist compresses can feel soothing.
- First week: most people return to everyday activities after 1 to 2 days. Hard and crunchy foods should be avoided for at least five days.
- First months: according to Cleveland Clinic, the graft needs at least three months to heal, and large grafts 9 to 12 months.
If bone was added near the sinus, extra rules apply; see our guide sinus lift.
Are small granules in the mouth normal?
Yes, in the first days it is usually normal for a few granules to come out of the site. Cleveland Clinic says these particles of graft material look like grains of sand or salt and are generally no cause for concern. According to McGill, they can appear for a few days to weeks.
Do get in touch, however, if:
- a large number of granules comes out (Cleveland Clinic)
- the particles cause clear discomfort (McGill)
- at the same time the stitches open, pus appears or there is a foul smell
When are the stitches removed, and can that be done at home?
Stitches are usually removed after one to two weeks or dissolve on their own. The sources give:
| Source | Stitches |
|---|---|
| Guy’s and St Thomas’ (graft with bone from the jaw) | Removed about a week later |
| China Medical University Hospital | Removed at the review appointment after one week |
| McGill University | Dissolving stitches fall out by themselves after 1 to 3 weeks |
For patients from abroad this matters, because your flight home may fall before the stitches are due out. The NHS treatment abroad checklist advises being clear about how your aftercare will be coordinated. Ask before the operation whether dissolving stitches will be used, and ask your dentist at home, ideally before you travel, whether they will remove the stitches if needed.
What should you pay attention to after a bone graft?
- Leave the site alone: do not touch it with your tongue or fingers, and do not pull your lip or cheek back to look (Cleveland Clinic).
- No vigorous rinsing or spitting: no rinsing at all on the first day; McGill advises avoiding vigorous rinsing for at least a week.
- No straws: China Medical University Hospital advises against them in the first week.
- Do not brush the graft site: Guy’s and St Thomas’ recommends a week, McGill at least five days; brush your other teeth as usual.
- Eat soft and lukewarm: avoid hard, hot and spicy foods in the first days.
- Do not smoke: according to Cambridge University Hospitals, grafts fail more often in smokers; Cleveland Clinic also advises against e-cigarettes (see smoking and dental implants).
- Postpone alcohol: Guy’s and St Thomas’ says at least 24 hours, Cleveland Clinic at least two weeks.
- No heavy exertion: Cleveland Clinic advises avoiding sport and heavy lifting for 48 hours.
- Take medicines as agreed.
Which symptoms are not normal?
Pain and swelling that increase after the first days instead of fading can be an early sign of infection or of a graft that is not healing. According to McGill and Cleveland Clinic, get in touch in the following cases without waiting for your review:
- Increasing pain or swelling after the fifth day (McGill) or after the first week (Cleveland Clinic)
- Pus or discharge from the graft site
- A bad taste or smell in the mouth
- Fever above 38 °C (McGill); Cleveland Clinic gives 38.3 °C as the limit
- Loss of many granules
- Gum that has opened, or a visible membrane or metal mesh
- Numbness of the lip or chin lasting longer than three weeks (McGill)
What happens if the graft is exposed or becomes infected?
Small openings often close with regular checks and care; an infected site may need cleaning. In the systematic review by Tay and colleagues (2020) in the International Journal of Implant Dentistry, minor infections occurred at 1.5 percent of lateral graft sites, and major complications with partial or complete removal of the material were reported in 1.6 percent of patients. Under the management they propose, small openings are observed with antiseptic gel and cleaning, larger openings may be closed again, and infected sites are cleaned and irrigated; an antibiotic is reserved for abscess, pus or general signs of infection. Have an opening or discharge looked at early, including by a dentist at home.
What happens if the graft does not heal?
If the graft does not take, the site may not gain enough bone for an implant; once it has healed, a repeat graft or a different treatment plan is considered. Guy’s and St Thomas’ points out that a graft does not always produce enough bone for an implant, that further procedures may then be needed, and that failure is more common in smokers.
After a new scan, the following options are usually discussed:
- Repeating the graft with the same or a different method or material
- Implants that suit the remaining bone, such as shorter or narrow-diameter implants (see our guide mini dental implants)
- A bridge or removable denture instead of an implant
If it is not the graft but the implant itself that fails to integrate, the approach is different; our guide when an implant fails explains it.
When can you fly home, and what happens afterwards?
There is little research on flying after oral surgery. An article in the British Dental Journal (2023) names two weeks as the earliest point after more complex procedures such as bone grafting or a sinus lift, provided there is no pain, swelling or bleeding, and presents these figures as a starting point for the dentist’s decision. When you may fly is set after the operation and according to how you heal; book a flexible return flight only once your plan is confirmed. How a bone graft affects the number and length of your trips is explained in our guide how many days do I need to stay in Türkiye for dental implants?.
The NHS checklist advises staying in the country of treatment for a suitable length of time to recover before travelling home, and the General Dental Council recommends that your own dentist knows about your plans in case of later complications. Tell your dentist at home before you travel and take your documents with you. During the months of healing you can send us questions and photos on WhatsApp; with acute symptoms, a dentist near you is the first port of call (see aftercare and follow-up).
How do we support healing after a bone graft at Rönesans?
We carry out bone grafting and sinus lifts at our clinic in Serdivan, and you know from the start which dentist is treating you. Before you leave, the wound is checked, and you receive copies of your treatment summary and X-rays. Whether the graft is ready for the implant is assessed at the start of your next trip with a cone-beam CT (CBCT) scan at our clinic.
If you notice unexpected swelling, discharge or fever at home, write to us on WhatsApp at +90 532 363 49 54 or call +90 264 606 09 43; during opening hours we reply to messages in English and German within 15 minutes.